Provider Demographics
NPI:1568802692
Name:MARSILLO, ALYSSA L (PA)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:L
Last Name:MARSILLO
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:3030 ORCHARD PARK RD
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-4638
Mailing Address - Country:US
Mailing Address - Phone:716-671-2507
Mailing Address - Fax:716-671-2508
Practice Address - Street 1:3030 ORCHARD PARK RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-4638
Practice Address - Country:US
Practice Address - Phone:716-671-2507
Practice Address - Fax:716-271-2508
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2023-04-28
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Provider Licenses
StateLicense IDTaxonomies
NY016597363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical